Organization
NEUROBLOOM BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE STAR HOLZWORTH (OWNER)
(910) 545-7561
Entity
Organization
Contact information
Practice address
1516 BERRIEDALE DR, FAYETTEVILLE, NC 28304-5503
(910) 545-7561
Mailing address
1516 BERRIEDALE DR, FAYETTEVILLE, NC 28304-5503
(910) 545-7561
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103G00000X
Clinical Neuropsychologist
—
—
103K00000X
Behavior Analyst
Primary
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
12/15/2025
Last updated
07/07/2026
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